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AT THE REQUEST of the American Academy of Pediatrics, the FY 2012 ICD-9-CM code update expanded subcategory 041.4, Escherichia coli, to create unique codes for Shiga toxin-producing Escherichia coli (STEC). This article describes STEC and its clinical features and summarizes the new STEC ICD -9 -CM diagnostic codes.
What Is STEC?
While most strains of common intestinal bacteria of the E. coli species are harmless, some strains are highly pathogenic. STEC is a major cause of bacterial enteric infections in the United States. It produces a toxin called Shiga toxin, which is sometimes referred to as verotoxin or verocytotoxin (VTEC). STEC and VTEC that cause human illness are also referred to as enterohemorrhagic E. coli (EHEC).
The most common STEC transmission is foodborne, such as the consumption of undercooked ground beef, unpasteurized juice or milk, and raw produce. Additional transmission modes include ingestion of contaminated water, contact with animals, and direct person-to-person contact.
The most commonly identified STEC serotype that causes foodborne outbreaks in the United States is E. coli 0157:H7 (0 157 STEC). The name originates from the serogroup classification: it has the 157th type of somatic (O) antigen and the seventh type of flagellar (H) antigen.
Many non-0157 STEC serotypes also contribute to foodborne outbreaks. They can present serious complications, as some strains can be very virulent.
The Centers for Disease Control and Prevention (CDC) have identified six non-0157 STEC serogroups (026, 045, O103, Olli, 0 121, and 0145) responsible for emerging non-0157 STEC illnesses, hospitalizations, and deaths in the United States.
Clinical Features and Diagnostic Testing
The CDC defines STEC as an "infection of variable severity characterized by diarrhea (often bloody) and...